Lecture – Evolving Treatment Paradigms for Transgender & Gender-Diverse Youth

Jack Turban, MD, MHS, Stanford University School of Medicine – Visiting Scholar Series

Transgender and gender-diverse youth populations experience high rates of depression, anxiety, bipolar disorder, substance use disorders, and other conditions. Suicide rates are also elevated in this group, driven by stigma, harassment, and discrimination.

“That is a big reason why I think psychiatrists should focus on trying to support these kids,” says Jack Turban, MD, MHS, child and adolescent psychiatry fellow, Stanford University School of Medicine.

In this talk, Turban explores the many health issues facing transgender youth and gender-diverse youth. He also looks at the ways treatment for this population has changed over the past 20 to 30 years.

The presentation highlights include:

• Identification of treatment approaches for prepubertal gender-diverse children and social transition
• Explanation of the rationale for pubertal suppression for gender dysphoria
• Description of the rationale for masculinizing and feminizing gender-affirming hormones for transgender adolescents

Though aimed at health care professionals, this talk is also helpful for parents and loved ones of transgender and gender-diverse children and teens.

Starting with early prepubertal childhood, “when kids might first start exhibiting some gender diversity,” Turban addresses the many treatment approaches aimed at this population. He also examines treatments used with adolescents and young adults. Drawing on research findings and case studies, he discusses conversion therapy and puberty blockers. He also discusses gender-affirming hormone treatment, “detransitioning,” and more.

Turban grounds his insights on the concept that gender identity is often “fluid” in these populations. “These things are not always binary or clear in the ways that we expect,” he states. “A lot of times, especially with younger people, they may not have decided. It may not be binary, so they may not identify as female or male.”

Given these “complex identities,” Turban calls on individuals to be aware of appropriate gender terminology and use correct names and pronouns. “When you use the wrong pronoun or you use a name that’s not their affirmed name, it often reminds them of the people from their past who didn’t accept them for being transgender,” he reports.

By examining evolving treatments and ongoing challenges, Turban’s talk gives mental health professionals important insights into approaches for addressing the mental health issues facing this population.